Association of asthma risk factors and the prevalence of the disease in a population of Brazil.

Summary: The objective of our study was to evaluate the association between the previously described asthma risk factors and the prevalence of asthma in a population of Brazilian adults. A population-based cross-sectional study was conducted using data collected from 7891 patients. All patients in the database > 18 years of age were included. The following variables were collected from the health plan database: age, body mass index, smoking status, alcohol consumption, sedentary lifestyle, heart disease, hypertension, diabetes, and asthma diagnosis. The frequency of the collected variables was compared between patients with or without an asthma diagnosis, and logistic regression was performed. Of our total sample (7891 patients), 150 (1.9%) had asthma. The mean age of patients with asthma was 39.4 years. 1.4% of normal weight patients had the diagnosis of asthma, while 2.4% of overweight and 2.2% of obese patients had the diagnosis. Multivariate analysis demonstrated that a sedentary lifestyle and overweight and obesity were independently associated with asthma prevalence Odds Ratio (OR) (95% confidence interval): (1.61 (1.16-2.22) and 1.25 (1.03-1.52) respectively). Our data provide evidence that some clinical characteristics, such as sedentarism, overweight, and obesity, may be related to the prevalence of asthma in an adult population in southeastern Brazil. Such factors could be modified and better understood through multidisciplinary research and health programs that evaluate the risk factors for asthma in large populations.

Disseminated Strongyloides stercoralis Infection in an AIDS Patient: The Role of Suppressive Therapy.

Patients with AIDS are prone to develop infections caused by opportunistic pathogens. Unusual agents, such as Strongyloides stercoralis, are being described in this syndrome, resulting in disseminated disease which is always severe and, in some cases, fatal. We describe a case of a patient with AIDS and Strongyloides stercoralis infection involving the gastrointestinal tract and the lungs. Therapy with thiabendazole for ten days led to resolution of the acute episode. Preventive therapy with 3g of thiabendazole once a week was then prescribed, and repeated fecal examinations were negative for larvae. Following discontinuation of treatment, however, the patient again had a positive fecal examination for Strongyloides stercoralis larvae, even though reinfection was considered to be very unlikely. The patient was retreated with a shorter course of therapy and once per week preventive therapy was reintroduced. After four months of follow-up, repeated fecal examinations were negative. When the treatment was changed to thiabendazole given once every two weeks, however, pulmonary Strongyloides stercoralis recurred. Subsequently, because of intolerance to thiabendazole, the patient was treated with cambendazole. The patient died three months later due to Pseudomonas aeruginosa pneumonia. Prolonged therapy for Strongyloides stercoralis infection may be necessary. Although further evaluation is needed, 3g of thiabendazole once a week may be adequate for this purpose. Cambendazole may be a useful alternative for disseminated Strongyloides stercoralis.